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KENYA: Caring for Nairobi's HIV-positive orphans

[This report does not necessarily reflect the views of the United Nations]

NAIROBI, 4 October (PLUSNEWS) - The six young children sitting down to lunch at Nyumbani Children's Home in the Kenyan capital, Nairobi, looked as healthy as any other children of their age.

There were all, however, children who had been abandoned at birth by their parents because they were HIV-positive.

"The children are abandoned because of the stigma attached to the HI virus. Members of the family are often unwilling to help when children are orphaned by AIDS," Sister Mary Owens, deputy director of Nyumbani, told a group of visitors from British Airways, one of the home's partners, on Monday.

Nyumbani, meaning "home" in Kiswahili, was opened in 1992 with the specific aim of caring for HIV-positive orphans who are abandoned by their parents or orphaned by HIV/AIDS.

"We currently have 94 children at the home," Nyumbani's Sister Tresa Joseph said. "We are totally dependent on donations and require between US $15,000 and $25,000 per month to finance all our projects."

Tens of thousands of Nairobi's children have lost their parents to HIV/AIDS, and most have little or no family support or medical care. It was with this in mind that the home's founder, Father Angelo D'Agostino, fondly referred to as "D'Ag", began the home.

The children at the home are all HIV-positive when they arrive, but because infants carry their mothers' antibodies through the first year of life, this is sometimes a "false" positive, and many never develop the disease and later test negative.

The home keeps those children who are eventually found to be definitely HIV-positive, providing nutritional, psychological and academic support, as well as life-prolonging antiretroviral drugs (ARVs). Children who eventually test negative when a definite assessment of their HIV status is made are either sent to other orphanages or adopted.

"Many of our babies and children have been adopted by people from as far away as the US, Italy and Holland," Sister Joseph said. "Those who are infected, we look after until they have completed school and learnt a trade that makes them self-reliant."

The home has a nursery school and sends the older children to four local primary schools. However, until 2003, when Nyumbani won a court battle against the government, the children were - on account of their HIV status - denied entry into government-owned schools where they could access low-cost education.

"Before the court case, we had to send the children to private school, which was obviously extremely expensive for us," Joseph said.

Nyumbani strives to create an atmosphere that is as close to a real home as possible, with the children living in "families" and "cottages". They have "mothers" who take care of them, and refer to D'Agostino as their "Dad".

While Nyumbani tries to allow the children to lead lives that are as normal as possible, a chilling reminder of the seriousness of their illness comes every so often when one of them passes away.

"We recently lost Samuel. He had been ill for some weeks and despite all the efforts of our medical team, he passed away," Protus Lumiti, Nyumbani's chief manager, said in the home's summer 2005 newsletter.

"It was hard on the other children. Not only have they lost a close friend, but for the elder ones, it raises questions in their minds about their own condition," he added.

BROADENING OUTREACH

Since its inception, Nyumbani has grown to encompass community based healthcare to reach the thousands of HIV-positive orphans in Nairobi's slums.

In 1998, it opened the USAID-funded "Lea Toto", a Kiswahili phrase meaning "raise the child", which provides assistance and medical care for HIV-positive children and their families using home-based care. They provide nutritional and medical support for them, and two months ago began to provide ARVs to the children.

"We are currently caring for 2,000 HIV-positive children in the slums and their families; about 300 of them are on ARVs," Sister Joseph said. "We have to follow them up to ensure they are correctly using the drugs. We have five out-stations around the city slums to help with this."

While all the children who need ARVs at Nyumbani are provided with the drugs, many vulnerable children in the Lea Toto programme must go without the so-called "Lazarus" drugs.

Nyumbani also has a laboratory, with the ability to test for HIV and several other infectious diseases. The state of the art lab provides services to other labs hospitals throughout Kenya.

In addition, construction of Nyumbani Village in Kitui district, about 250 km east of Nairobi, is ongoing. The village is intended to be a community to help orphans and elderly people left behind when their parents or children die of AIDS-related causes.

"The village so far has 32 houses as well as several boreholes and shallow wells. Kitui is very dry, however, and the village needs more water," Sister Joseph said.

The village is expected to care for and nurture up to 1,000 HIV-positive children once completed, and will provide housing, healthcare, counselling, education and vocational training.

To ensure sustainability, dairy farming and other income generating schemes have been planned for the 1,000-acre village. Funding has been provided by, among others, local authorities - who donated the land - as well as partners in the US and Italy.

As at the end of 2003, UNAIDS estimated that some 1.2 million Kenyans were living with HIV/AIDS, 100,000 of whom were children. The disease had orphaned some 650,000 children.

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